OBJECTIVES: To assess insulin dynamics to oral glucose tolerance testing in obese children, denoting individual contributions of insulin hypersecretion versus resistance to racial and etiopathogenetic specificity. STUDY DESIGN: We performed 3-hour oral glucose tolerance testing in 113 nondiabetic obese children (age 13.6 +/- 3.1 years; 41 male, 78 female; 37 black, 41 white; 35 with central nervous system [CNS] insult). The corrected insulin response (CIRgp; measuring beta-cell secretion) and the composite insulin sensitivity index (CISI) were computed and log-transformed, and each was modeled in terms of the other, plus race/etiology, age, sex, body mass index z score, glucose tolerance, pubertal status, and geographic location. RESULTS: A scatterplot of logCIRgp versus logCISI showed that racial and etiopathogenetic groups plotted in different areas. CISI (controlled for CIRgp and other variables) was only 13% lower in blacks than in whites ( P = .32). Conversely, CIRgp (controlled for CISI and other variables) was 49% higher in blacks ( P = .028). CNS insult exhibited a 40% higher CIRgp ( P = .054) and 11% higher CISI ( P = .42) than intact white subjects. CONCLUSIONS: Insulin hypersecretion and resistance are distinct phenomena in childhood obesity. Insulin hypersecretion appears to be the more relevant insulin abnormality both in obese blacks and in CNS insult.
OBJECTIVES: To assess insulin dynamics to oral glucose tolerance testing in obesechildren, denoting individual contributions of insulin hypersecretion versus resistance to racial and etiopathogenetic specificity. STUDY DESIGN: We performed 3-hour oral glucose tolerance testing in 113 nondiabetic obesechildren (age 13.6 +/- 3.1 years; 41 male, 78 female; 37 black, 41 white; 35 with central nervous system [CNS] insult). The corrected insulin response (CIRgp; measuring beta-cell secretion) and the composite insulin sensitivity index (CISI) were computed and log-transformed, and each was modeled in terms of the other, plus race/etiology, age, sex, body mass index z score, glucose tolerance, pubertal status, and geographic location. RESULTS: A scatterplot of logCIRgp versus logCISI showed that racial and etiopathogenetic groups plotted in different areas. CISI (controlled for CIRgp and other variables) was only 13% lower in blacks than in whites ( P = .32). Conversely, CIRgp (controlled for CISI and other variables) was 49% higher in blacks ( P = .028). CNS insult exhibited a 40% higher CIRgp ( P = .054) and 11% higher CISI ( P = .42) than intact white subjects. CONCLUSIONS:Insulin hypersecretion and resistance are distinct phenomena in childhood obesity. Insulin hypersecretion appears to be the more relevant insulin abnormality both in obese blacks and in CNS insult.
Authors: R H Lustig; F Greenway; P Velasquez-Mieyer; D Heimburger; D Schumacher; D Smith; W Smith; N Soler; G Warsi; W Berg; J Maloney; J Benedetto; W Zhu; J Hohneker Journal: Int J Obes (Lond) Date: 2006-02 Impact factor: 5.095
Authors: Robert H Lustig; Michele L Mietus-Snyder; Peter Bacchetti; Ann A Lazar; Pedro A Velasquez-Mieyer; Michael L Christensen Journal: J Pediatr Date: 2006-01 Impact factor: 4.406
Authors: Kristine A Madsen; Andrea K Garber; Michele L Mietus-Snyder; Joan K Orrell-Valente; Cam-Tu Tran; Lidya Wlasiuk; Renee I Matos; John Neuhaus; Robert H Lustig Journal: J Pediatr Endocrinol Metab Date: 2009-09 Impact factor: 1.634
Authors: Benedikt A Aulinger; Torsten P Vahl; Ron L Prigeon; David A D'Alessio; Deborah A Elder Journal: Am J Physiol Endocrinol Metab Date: 2016-03-15 Impact factor: 4.310